Case ReportLeptospirosis: a case report of a patient with pulmonary haemorrhage successfully managed with extra corporeal membrane oxygenation
Section snippets
Case report
A 30 year old previously fit and well man presented with a 4 day history of myalgia, nausea, vomiting, anorexia and jaundice. Initial examination showed jaundice with no signs of chronic liver disease. He was apyrexial with a BP of 119/80 mmHg, a pulse of 101 bpm and oxygen saturations of 99% on air. Clinical investigations demonstrated moderate renal impairment, liver impairment, anaemia and thrombocytopenia (Table 1).
Soon after admission the patient had an episode of haemoptysis associated with
Discussion
Leptospirosis is generally acknowledged to be the commonest zoonosis in the world. It is caused by anaerobic spiral bacteria (or spirochete) from the genus leptospira. There are more than 7 distinct species of pathogenic leptospires and at least 250 serological variants or serovars. The most important reservoirs of infection are rodents especially rats and these are responsible for most human infections worldwide.5 Other host animals include sheep, cows, pigs and dogs. Humans become infected
Acknowledgements
Mr H. Killer, Manager ECMO unit Glenfield Hospital Leicester; Mr R.K. Firmin, Co-director ECMO unit Glenfield Hospital Leicester; Dr A. Todd, Consultant Clinical Scientist Carlisle Public Health Laboratory; Dr T.J. Coleman, Consultant Microbiologist Leptosira Reference Laboratory, County Hospital, Hereford; Dr G. Avery, Consultant Radiologist Castle Hill Hospital, Cottingham.
References (23)
- et al.
Pulmonary complications of leptospirosis
Clin Chest Med
(2002) - et al.
Leptospirosis presenting as diffuse alveolar haemorrhage: case report and literature review
Chest
(2003) - et al.
Massive pulmonary haemorrhage caused by leptospirosis successfully treated with nitric oxide inhalation and haemofiltration
J Infect
(1999) - et al.
The molecular adsorbents recycling system based on albumin dialysis: a summary of preclinical investigations, prospective, randomised, controlled clinical trial and clinical experience from 19 centres
Artif Organs
(2002) - et al.
Evaluationof diagnostic tests for human leptospirosis
Braz J Med Biol Res
(1996) - et al.
Epidemic leptospirosis associated with pulmonary haemorrhage—Nicaragua 1995
J Infect Dis
(1998)